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Audio drops out when recording video on iPhone
How to remove sound when photographing without jailbreak
How to turn off camera sound on iPhone?
Disabling camera shutter sound using jailbreak
Removing sound using programs and applications
How to unscale video on iPhone
Movavi Video Editor
iPhone Video Recording No Sound Front or Back Camera in iOS 13/13.4. Fixed
Removing sound using the CloudConvert service
Sound works only in headphones
Cleaning the iPhone speaker
No sound during a call: checking the volume level
What to do if iPhone sound is not working
Restart iPhone
System crash
Sound drops on iPhone: solution
Resetting everything
Moisture ingress
Downed mode
Damaged speakers
iPhone Audio Keeps Cutting Out on iPhone 11 Pro Max, XS Max, X, 8 Plus & 7 in iOS 14/13.6. Fixed
Force reboot
No sound during screen recording on iPhone
Make sure screen recording is turned on
Factory Reset iPhone
Screen recording doesn't work on iOS 11/12. what to do?
Screen recording with sound is not recorded on iOS 11/12
Recover iPhone with Tenorshare ReiBoot
Sound doesn't work on iPhone
Causes of malfunctions and ways to solve them
What you need to fix the device
What problems can you fix on your own
Faults requiring special training
For what reasons, the sound recording may be missing on the gadget
System crash in iPhone software
Audio Microphone has not been activated
How to reset a gadget to factory settings
Why iPhone screen recording is silent
Why the audio on the video disappeared on the iPhone?
Why is there noise when recording video on iPhone and what to do about it?
Why is there no sound on the iPhone
Headphone malfunction
I solved my sound problem! iPhone video sound fading in and distorted ? Follow these steps
Alert settings
Hardware failure
You don't need to jailbreak your iPhone and do other weird things to take pictures in silence.
After all, all actions are easy and simple to perform without using a jailbreak:
Few people know :), but you can turn off sound alerts simply by turning on silent mode. To do this, use the switch on the side of the device.
Another secret information. if the silent mode switch is suddenly broken, then similar actions can be done by going to Settings. Sounds. Call and warnings. Unscrew the slider to a minimum.
You can also take pictures silently as follows: in the standard Music application, turn on the song, then simply turn down the volume until it disappears completely. But we do not stop the song itself or turn it off. We minimize the Music application, go to the camera and take a photo. you will not hear "clicks".
As we know, you can take pictures while filming. This also happens silently, despite the maximum speaker volume. However, other noises may be added, but that's a slightly different story. This method is bad because it will take a lot of memory and the quality of the resulting images will be lower.
You can connect headphones to the iPhone and then all sound notifications will be "sent" to them. Plus, it becomes possible to take a picture using the volume up button on the headphones. Those who do not want to carry a lot of wires can make a plug from old non-working "ears". To do this, simply cut off the plug and insert it into the 3.5mm jack on the iPhone. Compact, beautiful (well, how do you do it) and silent!
Let's move on to more radical solutions
Good time! I don't know why you needed to conduct silent shooting (for example, I was never annoyed by the characteristic "click" of the camera shutter) on my iPhone, but I really hope that for some good and kind purposes. as our beloved Minister of Sports says "everything there must be a know-how of criminality ":). And since the goal is good, then you can help! In the end, this is exactly what this site was created for.!
In fact, there are quite a lot of ways to turn off the camera sounds (and not just through the settings, as it might seem at first glance). What are these methods? Now we will deal with all this Let's get started!
Well, to be more precise, by replacing the corresponding file. Jelbreak is needed only in order to gain full access to the system and get to the file responsible for the sound when photographing. I will not tell you how to jailbreak. here it will not work out in a nutshell. Therefore, those who have it read on, and the rest can only use the methods indicated above or learn how to hack the device (if the camera clicks are very annoying).
We connect the iPhone to the computer and using any file manager, for example, iFunBox or iFile, open the folder along this path / System / Library / Audio / UISounds. Here you need to find the photoShutter.caf file.
Change its name to any, it is better to just add 1 digit. Having received something like photoShutter1.caf. What is it for and why can't you just delete it? It's just that this way you have the original file and you can always return it back.
Download this file (link to Yandex.Disk) and replace the original photoShutter.caf with it.
We try to take a picture and enjoy the fact that everything happens silently!
Why bother with all this jailbreak, file system and other things??
The fact is that there are iPhone models on which the sound cannot be removed in any way, except for this. They are intended mainly for sale in the markets of Asian countries (Japan, Korea, etc.), where such things (turning off the sound of the camera shutter when photographing) are prohibited at the legislative level, which means that it will not work out in the usual ways.
When choosing a program for removing audio recordings from videos for iPhones, you need to use the provided opportunities when working with an audio track, namely:
cropping, cropping, combining video clips;
application of effects: filtering, overlays, etc.;
viewing the modified video without leaving the program;
simplicity of the interface.
You can highlight an audio file from any video on iPhone and delete it. You can turn off the sound on the video on the iPhone using special programs or the button located on the side. The functionality of the former allows you to completely erase the audio recording, as well as fragments. All actions can only be performed using an Apple device. It is not necessary to use a computer.
The program is downloaded from the Internet and installed on your computer. Steps to follow when using Movavi:
Launch.
Moving the video. Click "File". "Add media" or move with the mouse.
Removing sound. Left-click on the sound icon. It will turn red and crossed out.
Saving a video file. Click "File". "Save movie to media file", select the format in which the clip will be played and save the movie to your computer.
We recommend saving the video in mp4 format so that the iPhone can play it without any problems.
In the absence of the necessary application, you can also make a video without sound on the iPhone online. There are several ways, one of them is editing in an online service, for this:
Find and open the cloudconvert.com website in any browser (it is better to work on a computer).
Click on Select files.
In the window that opens, find the desired video, open it (it will take some time to download).
Press the button with the image of a wrench.
In the Audio Codec line, select "None (remove audio track)", then Ok.
Click on the Start Conversion button.
When the operation is complete, click Download.
The algorithm of actions for this method is as follows:
Launch the iMovie app and create a new project.
Click "Movie" and select a video.
Click on the timeline. a yellow frame appears. Move the volume slider all the way to the left to remove the sound on the video, and click "Finish".
We save the finished movie without sound to any folder.
The ability to remove noise from videos that annoys hearing is provided by special applications or smartphone functions. This allows you to view the recordings calmly, without being distracted by extraneous sounds. If necessary, the video can be dubbed at your own discretion.
The external speaker stops playing sounds because the phone is still in headset mode. There are various reasons for this failure, for example, moisture or dirt has got into the connector, but there are also cases when a software error is to blame, as well as damage to the speaker due to impact.
Like all devices, iPhones also have lags, so the very first thing to do to fix the problem is to restart your iPhone.
If, after rebooting, the sound does not appear, then you need to carefully clean the 3.5 mm jack from dust and dirt. This can be done with a toothpick, twisted napkin or cotton swab.
Clean the power connector in the same way.
In case of a software error, which usually occurs after updating the iOS version, you just need to first connect the headphones, then connect a wireless speaker or headset, then disconnect the headphones.
If none of the methods helped, then you need to contact the service center and carry out diagnostics.
The earpiece speaker for iPhone is exposed to dirt and dust. Cleaning the earpiece is an effective way to troubleshoot no sound on your device during a call.
Use a small, sharp, non-metallic object (such as a toothpick) to remove dust and debris from the receptacle, or a soft bristled toothbrush.
In addition, this method of cleaning the speaker can be an effective preventive measure.
To check the preset volume level on your iPhone, use the volume buttons on the side panel. Therefore, check the volume setting on your device before making or receiving calls.
READ How to factory reset an Honor phone
Agree, there is little pleasant in the fact that you cannot listen to music on your favorite iPhone, or in a situation when problems with sound do not allow you to answer an important call in time. The problem is serious and needs to be solved as soon as possible.
Restarting your iPhone is one of the most effective ways to fix any problems with your device, including no sound. To restart, turn iPhone off and on again.
By the way, you can try one very tricky trick. It helps when everything is in order with the phone itself. After all, if the sound on the iPhone disappears, you can complain about the usual system failure. Such phenomena can happen on any phone for various reasons.
Usually the situation is subject to a simple correction. First, you can restart your iPhone. Reboot the system. Here's what will help to get all settings back to normal and eliminate even minor glitches. This is not my favorite trick.
Subscribers often use one trick: if you lose sound on your iPhone, plug it in for a while and then unplug the headset. Headphones. here's what will help you deal with the situation. This method is very helpful. In any case, this is what most iPhone owners say.
Often, users complain about a situation in which sound disappears on the iPhone. And it doesn't matter which model you have. This problem can still bother even the most careful and thrifty person. To be honest, there are a lot of options for the development of events. But we will try to fully deal with them. Why is there no sound on my iPhone? What to do in this or that case? All this will be discussed now.
Don't want to look for a long time for the cause of the breakdown and loss of sound? Then you can try to do without it. It is enough to reset all iPhone settings to the initial ones. If the reason lies in the operating system of the device or some kind of failure, then it will be eliminated. When can you try your luck? For example, if you lost the lock sound on iPhone.
How to bring your idea to life? Go to smartphone settings. There you need to select the "General" tab. "Reset". Take a close look at all the points that the system will offer you. Here click on "Reset all settings". Now you have to wait a while. Don't be alarmed if the iPhone restarts immediately after processing your request. This is quite normal.
You can see what happened. Practice shows that resetting the settings to the initial ones not only returns the sound, but also generally improves the operation of the smartphone operating system. True, it will take a long time to set up call ringing again. This is not such a big problem compared to the sound disappearing on the phone.
What to do if sound disappears on iPhone? It all depends on the situation. Sometimes the cause of this problem is the ingress of moisture into the device. Talking on your smartphone in rainy weather? Dropped it into the water? Then don't be surprised at the problem! Any phone starts to "glitch" when it comes into contact with water. By the way, high humidity in the room can also cause the sound to drop out.
Here everything is solved quite easily. If the sound disappears on the iPhone (or it disappears altogether) due to moisture getting into the device, it must be dried. Disassemble the phone as much as possible, and then blot each component with a towel. Dry all parts carefully with a hair dryer. The faster you do it, the better.
What's next? Once the entire smartphone is dry, you can reassemble it and test its functionality. Practice shows that the sound problem usually disappears. You should not be limited only to these cases. Sometimes the sound on the iPhone drops for other reasons. Some of them are very easy to eliminate. And some are not subject to adjustment at all.
The first reason for our problem may be a banal reset of the set settings. That is, if you notice that you have lost sound on the iPhone 4, you should not immediately panic. Check if everything is ok with the settings.
Most likely, you will notice that you have a silent mode. It is enough to change it to any other, and the problem will disappear by itself. Basically, this is a very common case. But unfortunately, more often subscribers think about the problem if the situation is of a different nature. So what else could be the case? Why is sound disappearing on the iPhone??
The next reason. it is damage to the speakers in the device. This is also a very common case. And just he brings a lot of inconvenience to users. After all, before drawing such conclusions, you will have to exclude all other options.
If you find that you have lost sound on your iPhone or it is now quiet, it's time to check the integrity of the speakers. It is best to take the machine to a service center. They will tell you exactly what the problem is. If the speakers on the device are really damaged and refused to work, then only one thing will help here. their complete replacement. As a last resort. repair. But you shouldn't do this on your own. Again, you will have to contact service centers. No other way.
But there are also more unpleasant moments. For example, if we are talking about a pirated copy of the iPhone. Buyers very often complain about eternal problems with the operation of these gadgets. And the sound disappears on them very often.
What can be done? First, try all the suggested solution methods. Most likely they won't help. Secondly, if your copy of the iPhone is still covered by a warranty, you can use it. Just exchange your phone for a new one. It should be noted right away. this phenomenon is rare. Often buyers of fakes are left with nothing.
Then you can only sympathize. And to suggest from now on not using fake gadgets. Or learn to work with an iPhone without sound, or completely change your phone. But not on "pirate" anymore. There is no other way out.
Have you bought a new device and noticed the sound is dropping out on your iPhone? Most likely, the reason here lies in marriage. Do not hesitate, try to quickly solve the problem. How exactly?
Is the warranty expired? Take your iPhone for repair or replace it altogether. As you can see, there are enough cases when the sound disappears. And you don't always need to panic. It is often possible to cope with all the problems on your own. If you are afraid to make the wrong "diagnosis", contact your nearest service center. This will save you unnecessary headaches.
This method solves most of the problems. To force restart your gadget, follow these steps: For iPhone versions below iPhone X / 8/8 Plus:
Hold your finger on the power button, then, without releasing it, simultaneously hold your other finger on the HOME button (on iPhone 7/7 Plus, on the volume down button) 2. As soon as the screen lights up, first release the power button, and then after a few seconds another button. The device will be restarted and ready to work.
Quickly press the volume up button and release it. Then do the same with the Volume Down button. 2. Hold the side button until the Apple logo appears. After that, your device will be restarted.
Open Settings. Control Center. Customize Controls. 2. In the list of settings, use the "" button to add the "Screen Recorder" function to the Control Center. Now try to activate it through the control center widget and record a video from the screen.
If the screen recording function does not work on the iPhone, video and sound from the screen are not recorded, you can try to reset all settings to factory settings. In this case, all data on the device will be saved.
Open Settings. General. Reset. Reset All Settings. 2. Wait for the device to be ready for use.
With the release of iOS 11/12, users are finally able to use the function of recording video from the screen with sound. Before that, mobile users had to install third-party applications and tweaks to record video from the screen. And now all iPhone owners who have installed iOS 11/12 have this feature by default.
However, there were a number of people who ran into problems while recording from the iPhone screen. Here's what they post on the forums:
"Apple has finally added screen recording in iOS 11/12. I have been waiting for this for a very long time, but I was very upset when I tried it in action. I was unable to record video from the screen, audio and video are not recorded. Tell me what to do and how to fix the problem? "
If none of the methods solved your problem, and the screen recording function still does not work on the iPhone, video and sound are not recorded on iOS 11/12, then perform a device recovery. The best way to do this is to use the Tenorshare ReiBoot program. With its help, you can solve most of the problems by entering and exiting recovery mode. You can solve the problem "screen recording does not work on iPhone" in just a couple of clicks.
READ What the new iPhone will look like
Download and run Tenorshare ReiBoot on your computer, then connect your iPhone with a USB cable to your computer. In the program window, click on the "Fix all iOS freezes" button. Then click "Fix it now" and follow the further instructions. New firmware will be loaded.
When the process is complete, click on the start recovery button. After a few minutes, the device will be rebooted and ready to work.
Tenorshare ReiBoot is a versatile tool that can solve other common errors on iOS 11/12: stuck on a black screen or apple logo, if the display does not respond to your touch, if the iPhone does not exit recovery mode, or if it stuck on a blue screen of death etc. You can use it on both Mac and Windows, the download is free.
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How to deal with a loss of sound on iPhone? The solution to the problem depends on what caused the problem. It is not uncommon for the iPhone to have no sound when making a call, when playing music after an update, or due to a violation of the integrity of parts. The reasons that the sound disappears and appears may be associated with problems in the device settings, mechanical damage to the speaker.
Before proceeding with the repair of the device, the following details should be determined:
how does the malfunction manifest itself
a possible reason that there is no sound or the speaker sometimes turns off
how the device behaved before it broke
You can fix the problem when the sound on the iPhone is missing by yourself. In simple cases, complex diagnostics are not required to identify the reason why no sound is played during a conversation or when watching a video. Most of the faults are hidden inside the device itself, so it is enough to carefully disassemble the device and carefully inspect the condition of the components. If the sealed contacts of the microcircuit or other damage are not visible anywhere, contact the masters for help.
If you are faced with a problem when suddenly or after a short period of time the sound signal disappeared, you can solve it on your own. Even with a bad or intermittent sound, you should not hope that everything will go away by itself, but it is better to deal with the cause of the breakdown and eliminate it.
A typical list of reasons leading to the sound mutes on iPhone when calling or watching a video, listening to music, include:
reset of the set settings
speaker damage
audio channel pollution
If you wet or drop your mobile device, the hardware may be damaged. There will be no audio signal when mute is on. In this case, you can navigate by vibration. No ringtone sound will be heard in a completely discharged or disconnected device.
If you only feel vibration during a call, check the set volume level. The reason that you hear a poor audio signal when talking or listening to music may be due to clogging of the channels with dirt or dust particles.
In order to repair a device that has fallen or stopped playing a sound signal for another reason, you will need the following tools:
a set of screwdrivers with special tips for working with small screw heads and other connecting parts
The main thing that is necessary when servicing an iPhone, the sound on which does not turn on or changes abruptly, is the availability of a special tool and experience in repairing electronic devices. In the case when the sound works in the headphones, but not without them, check the settings. This sign may indicate that the device is constantly used in the headset-on mode. Changes can be made via the smart keyboard in the corresponding section of the menu.
The reasons for the malfunction, which led to the absence or deterioration of sound, may be hidden in the iPhone applications. If the ringtone beep is partially or completely lost, check the integrity of the buttons, iPhone settings. In the event of a normal system failure, you can restore the usual operability and functionality of the device that stopped working in a few minutes. To do this, you need to update the settings via the smart keyboard.
ingress of moisture under the body of the device
broken headphones or jack
faulty buttons
system crashes that led to the fact that sometimes or constantly mutes the sound while watching videos, playing games, working in applications
If the headset connector is broken, it should be replaced. In case of oxidation of microcircuits, it is necessary to clean the metal contacts.
Regardless of the performance of the iPhones, the following simple rules will protect you from problems associated with the lack of sound in your headphones:
use only trusted programs to update the software
avoid impacts and wear special covers to protect the devices from damage
do not use the device in dusty or humid environments
If you are not sure that you professionally check your mobile device and identify the main reason why the sound appears or is suddenly interrupted, contact specialists for help.
If the device is in a locked state, and the beep appears intermittently, it is necessary to check the integrity of the speaker, which is not working normally. The indicated sign may appear when playing games, watching videos.
This part of the device is damaged by the following influences:
strong continuous vibration, which leads to the destruction of contacts
If the device falls or you get wet, the microcircuit responsible for sound reproduction may fail. If it breaks down, the ringtone melody can sharply change its amplitude. This malfunction affects both operating devices and blocked ones.
There are several reasons why external audio may be missing from the video. Most often, there are only two problems:
the smartphone has a system failure;
user forgot to activate the microphone.
It is worth telling in more detail about how to fix the cause of the failure on your own. It is also worth considering in more detail each of the problems.
If the iPhone screen does not record sound, the problem may be a smartphone software crash. Every gadget can run into problems with the system. When the "Microphone" button is activated but no sound is recorded, the reason is a software error. In this case, it is recommended to first simply reboot the gadget.
As soon as the smartphone turns on again after restarting the system, you should check if it is possible to record sounds to the gadget. In the case when the video has a screen, but the user's voice is absent, you will have to switch to other methods. First, it is recommended to go to the section with the settings and select the "Software update" item. After going through this subsection, the screen will display information about the availability of new versions. If the firmware requires an update, it should be run.
When this method also did not help restore the operation of the device, you will have to restore the gadget. Before starting the operation, you need to create a backup. It is created through cloud storage or iTunes. After saving a copy, you can restore the gadget through iTunes or using the device settings.
To record the screen and comment on their actions, the owner must connect external audio. First, the user will need to enable the "Screen recording" option, it is located in the smartphone settings. To connect the main function, you need to follow the following instructions:
the client goes from the main screen of the cell phone to the "Settings" section;
further from the list the item "Basic" is selected;
when a new list is displayed on the screen, the client selects the "Restrictions" section in it;
the system will ask you to enter the password for the gadget account;
if the settings were not used earlier, you will have to set a new access code;
a new list will appear on the display, in it the "Screen Recording" service is selected;
a slider is located next to it, it is moved to the "Active" position.
When the option on the smartphone is activated in the settings, you can start creating a video. The user should remember that initially the shooting is carried out without sound. To connect it, you need to open the "Control Center" on the phone. There you will find the section "Screen Recording", the button is pressed and held for 5 seconds. The microphone icon will appear on the screen, you should click on it to activate.
Users are wondering what to do if iPhone screen recording is silent. In this case, the factory reset operation will help. To begin with, it is worth telling how to perform the procedure through the settings of a cell phone. To reset data, use the following instruction:
first, you enter the "Settings" of the smartphone;
then the item "General" is selected from the list;
the "Reset" subsection is selected on the screen;
now you should click on the item "Reset all settings".
Using this method, the data on the smartphone will not be deleted.
When it is impossible to use the settings of the gadget, you will have to resort to using the iTunes program. The procedure is performed according to the following scheme:
first, you need to connect the gadget to a stationary computer using a lightning cord;
then the smartphone must be removed from the lock;
after unlocking the gadget, the program will be able to check the installed firmware version;
as soon as the application on the computer starts, it will require disabling the "Find iPhone" option;
to do this, find the "Find My iPhone" item in the settings and deactivate the function;
a notification will appear on the screen with a proposal to save the data in a backup copy, you should refuse the offer.
READ How to download video to computer
The procedure ends by activating the "Restore iPhone" button. After that, the client will be able to use the gadget again and try to record with sound.
Sometimes, the user needs to record the smartphone display. Such actions are performed by players in the process of passing the level of an online game in order to show how to complete it. Also, the video may be needed as an example of how to perform this or that action through the phone. The owner has the option to record with internal sound only or connect a microphone. But there are situations when voice recording is not performed. In this case, you need to figure out why there is no sound when recording the screen on the iPhone.
Any electronics are inherently vulnerable, which is why problems happen with Apple devices. In particular, with the release of the iPhone 6, complaints about the sound disappearing in the phone have become more frequent.
The problem has different symptoms, so there are several solutions for it. If the audio on the video disappears on the iPhone, most likely the problem lies in the operating system. However, the reason may be the failure of one of the components of the phone.
Therefore, two types of problems can be distinguished: hardware and software. The first group includes:
Clogged / dusty headphone jack
If there is no sound in the headset, pay attention to the connection connector. The presence of any microparticles in the nest is unacceptable, so you need to take a small needle and carefully clean it.
Clogged / dusty speaker
The problem is solved in the same way as in the previous situation, however, cleaning must be approached with increased accuracy, since there is a high probability of damaging the speaker. It is also recommended to use a hair dryer to blow out dust from the speaker.
Equipment damage
Mechanical breakdown of a speaker is an infrequent situation. It can be solved only by repairing a part in a service center.
Software causes of problems are much more common. The following malfunctions appear:
Lack of video player audio codecs
The standard player suffers from a lack of sound extensions relatively often. The solution to the problem lies in the vastness of the App Store: you need to download the most functional video player (for example, KMPlayer or VLC).
The ringtone disappears, the songs are muted, the sound in Instagram on the iPhone disappears. all these problems are associated with "jailbroken" smartphones. Finding a solution to such a problem is simple: just remove "root for iOS" and return to the standard version of the device.
It is difficult to describe the causes of the problem, since it appears under a variety of circumstances (system update, installation of additional software, etc.). It is solved either by restoring the smartphone through a backup, or by completely resetting to the factory state.
IPhone owners rarely experience the inconvenience of no audio on video. Nevertheless, knowing the causes of malfunctions and how to fix them is useful so that such a situation cannot be taken by surprise.
Let's quickly go over the main signs and reasons why extraneous sounds are heard when playing a video recorded on an iPhone and, most importantly, how to remove them (preferably once and for all)?
Let's not postpone the matter let's get started!
And here's what can affect audio recording:
Films and covers! It happens that some films (often) and cases (rarely) that cover the back (iPhone 5 and older) or the side top (relevant for iPhone 4 and 4S) of the device are made a little incorrectly and do not take into account the design features of the phone. Thus, they cover the microphone intended for audio recording. This means that during video recording, there is either no sound at all, or it is quiet and with extraneous noise. Remove all accessories and check again.
Microphone is clogged or clogged. Needs to be gently cleaned with a brush or brush. We perform all actions very carefully, so as not to make unnecessary holes in the protective and decorative nets.
It is important where and how you record the video. If this happens in complete silence, then the so-called background noise, or rather even some hiss, is possible. The fact is that the microphone tries to "hear" the slightest sound and its sensitivity is greatly increased in silence, in fact, it "makes noise". Try to say something, he will "focus" on your voice and the hiss will disappear.
Perhaps the reasons lie in the rattling of some elements inside the iPhone and it is their sounds that are superimposed on the video.
We carry out the "standard set of Apple technical support tips":
Resetting the device.
We install the latest firmware.
Without restoring the iPhone from a backup, but setting it up like a new one, we try to record a video again.
If the problem persists and interferes very strongly, then
Best of all. official.
Perfect. under warranty.
Probably the microphone is broken / damaged (although, it happens that the problem is not in it, but in completely different hardware).
Here it is necessary to understand (in the literal and figurative sense of the word) and it is worth entrusting this matter to professionals. And, I repeat, it is very advisable to contact not a "handicraft" service in the nearest market, but an official workshop. it will be much more reliable.
iPhone, like any other device, can malfunction. If there is still no sound on the phone, and none of the methods described above has brought a positive result, you should suspect it is a system failure.
First, try restarting your phone.
Read more: How to restart iPhone
After rebooting, check for sound. If it is absent, you can proceed to heavy artillery, namely, to restore the device. Be sure to create a fresh backup before starting.
Read more: How to back up iPhone
There are two ways to restore iPhone: through the device itself and using iTunes.
Most of the problems with no sound are usually related to the iPhone settings. In rarer cases, a hardware failure may be the cause.
If the sound from the speakers is working correctly, but when you connect the headphones you do not hear anything (or the sound is extremely poor quality), most likely, in your case, there is a breakdown of the headset itself.
It's easy to check: just connect any other headphones to the phone that you are sure of. If there is no sound with them, then you can already think about a hardware malfunction of the iPhone.
Open any application with music or video, start playing the file and use the volume key to set the maximum sound value. If the sound is on, but the phone is silent on incoming calls, most likely you have incorrect notification settings.
To edit the notification parameters, open the settings and go to the "Sounds" section.
In the event that you want to set a clear level of the sound signal, turn off the "Change with buttons" parameter, and set the desired volume on the line above.
iPhone supports wireless devices such as Bluetooth speakers. If a similar gadget was previously connected to the phone, most likely the sound is transmitted to it.
It's very easy to check this. swipe up from the bottom to open Control Center, and then activate airplane mode (airplane icon). From now on, the connection with wireless devices will be disconnected, which means that you will need to check if there is sound on the iPhone or not.
If the sound appears, open the settings on your phone and go to the "Bluetooth" section. Move this item to inactive position. If necessary, in the same window, you can break the connection with the device broadcasting sound.
Next, call the Control Center again and turn off airplane mode.
Let's start with the trivial: if there is no sound on the iPhone on incoming calls or SMS messages, you need to make sure that the silent mode is not activated on it. Pay attention to the left side of the phone: there is a small switch above the volume keys. If the sound is muted, you will see a red mark (shown in the image below). To turn on the sound, just move the switch to the right position.
The following types of breakdowns can be attributed to a hardware malfunction:
Inoperability of the headphone jack;
Sound control buttons malfunction;
Sound speaker malfunction.
If the phone has been dropped in snow or water before, the speakers are likely to be very quiet or stop functioning altogether. In this case, the device should dry well, after which the sound should work.
In any case, if you suspect a hardware malfunction without proper skills in working with iPhone components, you should not try to open the case yourself. Here you should contact the service center, where competent specialists will perform a full diagnosis and be able to identify, as a result of which the sound stopped working on the phone.
No sound on iPhone is a frustrating but often fixable problem. If you have encountered a similar issue before, please share in the Комментарии и мнения владельцев how it was resolved.
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A package of 3 Black Boston pin-on buttons which reflect the year 1638, when a small group of enslaved Africans arrived in Boston and established the first Black Boston community.
A package of 3 Black Boston pin-on buttons which reflect the year 1638, when a small group of enslaved Africans arrived in Boston aboard a merchant ship named "Desire." The Governor of Massachusetts at the time issued the equivalent of an executive order to define who enslaved people were and what their legal rights in early Boston would be. The wording distinguished the enslaved from free people and gave Boston's 3,000 residents the right to use the enslaved to perform work, build the economy and fight wars. The word "Slave" was rarely if ever used in Early Boston at the time.
The AMAZING thing is ..like the Pilgrims who arrived in Massachusetts, survived hardships and gave births to the ancestors of people living today who can accurately trace back to the Puritans of Plimoth Colony, the Africans did the exact same thing, however; the lack of documentation prevents a living Black Bostonian to trace their origin back to this original 1638 cohort.


Economides & Goldberg, Consulting Engineers, New York, N. Y.
The Cooper Union, Cooper Square, New York, N. Y.
Lau W, Tan CW. Errors in One-Dimensional Heat Transfer Analysis in Straight and Annular Fins. ASME. J. Heat Transfer. 1973;95(4):549-551. doi:10.1115/1.3450110.


text:
BM Show
Latest GatorBait News
Buddy Martin
Listen up SEC! Auburn-Florida rivalry renewal could be an antidote to college football ills
BY BUDDY MARTIN
GatorBait Editor
These kinds of games come along every 25 years or so. In the case of Florida-Auburn, exactly 25 years ago. Two former rivals, both unbeaten and ranked in the Top Ten, locked in a Lollapalooza of college football game.
In 1994, with a guy named Spurrier was coaching and a guy named Nix (Patrick) was pitching the winning touchdown in the final ticks. No. 6 Auburn pulled off an epic 36-33 upset over No. 1 ranked Florida in The Swamp.
Here we are two and a half decades later with another guy named Nix (Bo) playing quarterback for the Tigers on a field named after Steve Spurrier, two undefeated teams renewing an old rivalry – No. 7 Auburn a field goal favorite over No. 10 Florida.
Topped off with the Gators wearing vintage throwback uniforms from the Spurrier Era in a Homecoming setting featuring ESPN Game Day on campus.
All of college football could benefit by taking notes and noticing our cover with the Two No. 11s featured over Kassidy Hill's brilliant headline "Back to the Future." The perfect Old School/New School blend. This is good for what ails college football. In more ways than one.
What beautiful symmetry is spawned by this déjà vu. This game could be epic whether it turns out close or not, just because of the organic spirits which are bound to be stirred up in The Swamp. And it answers two mega-questions:
Is Auburn a dilletante masquerading as an emerging No.1, as some so-called experts are saying? On the other side, could the revival of the Florida Gator football brand with the start of a four-game Murderer's Row of Top Tens: Auburn, LSU and Georgia?
Murderer's Row is not new to Dan Mullen. He's fought his way out of it before. Remember, he coached in that SEC West division full of Tigers and the Tide.
The season was 2014, full of serendipitous success, and the Bulldogs were on top of the world, holding on to the No. 1 ranking for four weeks. First time ever for Mississippi State. Mullen was sashaying down his own Mississippi State Murderer's Row.
"At Mississippi State we played (No.) 2, 4 and 6 in consecutive weeks," Mullen recalled. "It was actually 6, 4 and 2 in reverse order. We played No. 6, won, we played No. 4, won, played No. 2, won." Actually, depending on what poll is used and when, it was No. 8 LSU, No. 6 Texas A&M and No. 2 Auburn at the time they played. Still impressive. Nine straight wins by the Bulldogs.
The problem is that Mullen's team couldn't hold serve and lost three of its last four games to Alabama, Ole Miss and Georgia Tech. After a 10-3 record and a No. 11 finish in the final poll, however, Dan Mullen had made his bones.
Once again, it's on. Mullen is 19-3 at Florida with 9 straight wins. The last time his Gator team lost was almost exactly a year ago when it was knocked off by Missouri. Not a ton of love from the national media, but sneaky little building blocks have gotten Florida to the precipice of SEC contention which will be determined after Murder's Row:
No. 7 Auburn, No. 5 LSU in Death Valley, with unranked South Carolina following and then an open date before No. 3 Georgia.
The bright lights will be shining on Gainesville this week, conjuring up such a rich history. You can go all the way back to Spurrier's playing days when he struggled at Auburn in a loss which featured the ballhawking of a linebacker named Bill Cody from Orlando, who picked off one of his passes and caused him to fumble. Or the next year when Spurrier kicked the winning 40-yard field goal on Florida Field to beat Auburn 30-27 which probably won him the Heisman.
Then as a coach at Florida Steve beat those Tigers from the Loveliest Village on the Plains like a dusty rug, 10 x 13 times. One of the times he didn't was that 1994 game when Patrick Nix hit Frank Sanders for the winning touchdown.
Now comes another No. 11 to try his hand. Kyle Trask may have to get the ball out quicker against Auburn's stellar defensive line. Ironically, he'll be wearing a similar uniform to what Spurrier wore 1964. And the same number.
If you can't get jacked up about this weekend, then have your cardiologist check you for a heartbeat.
Nostalgia prevails, but the reality is that the Florida-Auburn is just what the doctor ordered to spice up some feeble cupcake schedules for which fans are sick of buying overpriced tickets. I've heard all the yada-yada-yada about scheduling problems and don't buy it. Still no good reason why they can't get this rivalry back on the front burner, but the truth is that is must be done now, somehow someway if the SEC is serious about the integrity of the game and getting rid of the ripoff prices for those cupcake games. No wonder CFB attendance is falling like the Dow-Jones of March 2009.
Paul Finebaum agrees. "It's and going to something drastic before somebody does something," Finebaum told me on the Buddy Martin Show. "It's like it takes a heart attack sometimes before we start being concerned about our health."
Finebaum has not been on the Gator bandwagon, which is why I was surprised to hear him say Florida has a real shot at Auburn, pointing out that this is the first trip to The Swamp for both Bo Nix and Gus Malzahn. "Of those three big games (Auburn, LSU and Georgia) Florida's best chance is against Auburn," he said.
Meanwhile, we've got this to live for:
Lollapalooza definition: A person or thing that is particularly impressive or attractive.
Last year's crowd buzz for LSU was the loudest we've heard in a long time. Will Saturday's game equal it?
Even Dan Mullen had a little extra juice this week when he talked about his days of coaching against Auburn – and what life was like in the West when Mississippi State was batting its own version of Murderer's Row.
"I've gotten an opportunity to play a lot of top 10 teams. (he laughs). I just wasn't always Top 10 at the same time as a head coach. But I love them. This is what it's all about. These are a lot of fun. These are fun games to be a part of."
This being the first time since 2007 that the Tigers have been to The Swamp, Mullen pause to reflect on a return to a regular home-and-home series which he hopes could happen someday.
"I think it would be great to get to play for the players," said Mullen. "I think for the fans and for the players to have these games be played more often would be benefit for everyone. That's why you want to come in the SEC, to play big games and to play other SEC schools. So I think it would be great for these games to be played more often."
And then there is "The Battle of the Visor Coach."
It is believed that Malzahn started wearing his visor when he was a high school coach. Mullen began wearing one as a rookie coach at Wagner College.
"I wasn't really the first one," Spurrier said. "Maybe the first one in college. The Green Bay Packers were playing the Rams in the Coliseum one hot sunny day. And Vince Lombardi was wearing one. (Bill) Belichick wears one every now and then. Maybe I was the first in college ball."
Somebody noted to Mullen than Malzahn was a "Visor Coach" as well. His inspiration was also Spurrier.
"That's all right," Mulled wisecracked on the way out of the presser. "We've got Coach Spurrier!"
Thoughts of the Day: January 15, 2021
Alabama Wins Sixth Title Under Saban; How Far Off Are Dan Mullen and the Florida Gators?
Buddy Martin Blog: College Football Met One Challenge. Another Awaits Around The Corner. Just Do It!
College Football showed its ability to change in 2020. Now it's time to change some things for good, for the betterment of the game.
gatorbaitmedia@gmail.com
© 2021 GatorBaitMedia. All rights reserved.

redpajama_set_name: RedPajamaCommonCrawl


FORT KNOX, Ky. – The family of a Fort Knox soldier last seen visiting his parents on Thursday in Sarasota, Fla., has reported him missing.
The Manatee County sheriff's office in Bradenton, Fla., says Pfc. Daniel Dezinno left his parent's home to return to the central Kentucky military post but hasn't reported or been heard from since.
Relatives say they contacted the Florida Highway Patrol and Georgia Highway Patrol, but no one reported seeing the 30-year-old soldier.
Sheriff's department spokesman Dave Bristow says Dezinno's credit card was last used Friday. Bristow says Dezinno's phone was shut off the same day.
Bristow says there is no evidence indicating foul play or that Dezinno might be in danger.
Dezinno may be driving a 2005 silver Subaru sedan with Kentucky tag 168PHP.


Peep Show is an 8-minute short film directed and produced by Charlie Call, produced by Gary Bryman, and written by Damon Jones and Bob Kirsh, starring Jones, Kirsh, and Jane Leyden. The film screened at over 100 film festivals in 1999 and 2000, winning 15 "Best Short Film" awards. It has continued with encore screenings since 2000, most recently at the Hardacre Film Festival in Tipton, Iowa in 2012, the Mendocino Film Festival in Mendocino, CA June 4-6, 2010, and the Cinema Society of San Diego's 25th Season Premiere in September 2008, and at the Director's Guild theater in New York in March 2007.
Peep Show is one of a small number of short films to be licensed and run on HBO and released as a stand-alone DVD by Columbia-TriStar and is still available on amazon.com and ebay. It is also available as a selection on Netflix and Blockbuster online.
You can email the makers of "Peep Show" at charliecall @ hotmail.com to find out more about the film, and information on where and when you can see it again.
about the film, and information on where and when you can see it again.
Copyright . Charlie Call. All rights reserved.


text:
Things I Wanted To Say But Never Did | Matt Dunne
Matt Dunne | Artist
Exhibiting artist at 'Things I Wanted To Say But Never Did' | Group Exhibition.
Opens to the public 4th September 2019, 6pm - 8pm.
I walk to day dream and feel better about a lot of things that upset me and, in doing so, make photographs while exploring. My work is often quiet and fecund and all I seek to do is make an emotion, mood or tone visible. I used to work with at risk youths as a teacher, and often they reminded me of the parts of myself I wanted to forget.
What can the audience expect of your response to the theme?
I've responded by pulling a piece of writing I didn't have the guts to send to a student I worked with and an image of weight.
Describe yourself in 3 words.
Joyful. Naïve. Blunt.
If you could say 1 thing to an ex lover, what would you say?
I'm sorry it took me most of our relationship to work out how to be a better man, I'm constantly upset that you were subjected to someone working things out. It really wasn't fair.
ARTIST BIO: Matt is a photographic artist living and working in Melbourne, Australia. Drawing his background in Literature, his work focuses on approaching the world with an open mind. He creates photographs reflective of place and mood by making images that are simultaneously direct and lyrical. More interested in the backyard than drama, Matthew's images are made through using long stretches of walking around the suburbs to create art that is about time, memory, place and surrender.
Follow Matt on Instagram here: @matt.dunne
Website: www.mattdunnephoto.com
https://contactsheet.com.au/blogs/exhibitions/things-i-wanted-to-say-but-never-did-exhibition


text:
Fluorescent Indocyanine Green versus Technetium-99m and Blue Dye for Bilateral SENTinel Lymph Node Detection in Stage I–IIA Cervical Cancer (FluoreSENT): protocol for a non-inferiority study
http://orcid.org/0000-0003-0534-7778Ilse G T Baeten1,
Jacob P Hoogendam1,
Arthur J A T Braat2,
Wouter B Veldhuis2,
Geertruida N Jonges3,
Ina M Jürgenliemk-Schulz4,
Ronald P Zweemer1,
Cornelis G Gerestein1
1Department of Gynaecologic Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, Netherlands
2Department of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, Netherlands
3Department of Pathology, Division of Laboratory, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
4Department of Radiotherapy, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, Netherlands
Correspondence to Ms Ilse G T Baeten; i.g.t.baeten{at}umcutrecht.nl
Introduction Nowadays, two predominant methods for detecting sentinel lymph nodes (SLNs) in cervical cancer are in use. The most conventional method is a combination of a radiotracer, technetium-99m (99mTc) and blue dye. More recently, another method for SLN mapping using indocyanine green (ICG) is becoming widely accepted. ICG is a fluorescent dye, visualised intraoperatively with near-infrared (NIR) fluorescence imaging, providing real-time visual navigation. The presumed advantages of ICG over 99mTc, that is, being cheaper, non-radioactive and logistically more attractive, are only valuable if its detection rate proves to be at least non-inferior. Before omitting the well-functioning and evidence-based combined approach of 99mTc and blue dye, we aim to provide prospective evidence on the non-inferiority of ICG with NIR fluorescence imaging.
Methods and analysis We initiated a prospective non-inferiority study with a paired comparison of both SLN methods in a single sample of 101 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA–IB2 or IIA1 cervical cancer receiving primary surgical treatment. All patients undergo SLN mapping with ICG and NIR fluorescence imaging in adjunct to mapping with 99mTc (including single photon emission computed tomography with X-ray computed tomography (SPECT/CT)) and blue dye. Surgeons start SLN detection with ICG while being blinded for the preoperative outcome of SPECT/CT to avoid biased detection with ICG. Primary endpoint of this study is bilateral SLN detection rate of both methods (ie, detection of at least one SLN in each hemipelvis). Since we compare strategies for SLN mapping that are already applied in current daily practice for different types of cancer, no additional risks or burdens are expected from these study procedures.
Ethics and dissemination The current study is approved by the Medical Ethics Research Committee Utrecht (reference number 21–014). Findings arising from this study will be disseminated in peer-reviewed journals, academic conferences and through patient organisations.
Trial registration number NL9011 and EudraCT 2020-005134-15.
Nuclear radiology
Gynaecological oncology
We perform a powered, prospective non-inferiority trial comparing the bilateral sentinel node detection with indocyanine green (ICG) versus the combination of radiotracer (including preoperative imaging) and blue dye in cervical cancer.
The Fluorescent Indocyanine Green versus Technetium-99m and Blue Dye for Bilateral SENTinel Lymph Node Detection in Stage I–IIA Cervical Cancer (FluoreSENT) study is designed for intrapatient endpoint comparison, which increases statistical power and—contrary to a randomised controlled trial—allows for a direct comparison of detection rate and sentinel lymph node (SLN) anatomical localisation of the different tracers.
In the presented design, surgeons are blinded for the outcome of the radiotracer when starting SLN detection with ICG.
A limitation of this study design is the lack of blinding for the outcome of blue dye, which is visible with the naked eye.
Lymph node status is the strongest prognostic factor of survival in patients with cervical cancer and influences therapeutic management,1 highlighting the importance of nodal assessment. To assess nodal stage accurately and efficiently in patients with early-stage cervical cancer, sentinel lymph node (SLN) mapping has emerged and could play a fundamental role in reducing the need for full pelvic lymphadenectomy. International studies are under way to assess the performance of SLN resection alone versus pelvic lymphadenectomy in cervical cancer treatment.2 3 For SLN mapping to be considered reliable, adequate detection and resection are essential. Since the cervix is a midline organ and lymphatic drainage is conducted bilaterally, high bilateral detection rates (defined as the proportion of patients with at least one SLN detected in each hemipelvis) are crucial for reliable SLN mapping.4
For mapping the SLNs, the conventional combined approach of radiotracer technetium-99m nanocolloid (99mTc) and blue dye previously has been proven to yield superior bilateral detection rates compared with using one of these tracers alone.4–9 The radiotracer 99mTc enables preoperative imaging with SPECT/CT, while blue dye is added during surgery to visualise lymph nodes and afferent lymphatic vessels. However, certain disadvantages exist. Use of 99mTc with SPECT/CT exposes patients to ionising radiation. Intraoperatively, use of 99mTc only gives acoustic feedback and, with conventional gamma probes, is unable to provide real-time visual guidance. The 'long' radiotracer protocol (ie, 1-day preoperative admission for SPECT/CT) can be logistically challenging (demanding a nuclear medicine unit with safety protocols for handling), time consuming, involving longer hospital stay and leading to higher patient burden. Also, 99mTc usage is costly, especially in combination with preoperative SPECT/CT. Although the combination with intraoperative use of blue dye is beneficial in terms of bilateral detection rate, in a subset of patients, blue dye is associated with allergic reactions that may be severe (around 0.6%).9 10 Common adverse effects related to blue dye are localised swelling or pruritus (2%–4%), transient discolouration of skin and urine (>95%) and a decrease in pulse oximetry readings due to colorimetric interference.11 12
The aforementioned disadvantages contributed to the recent shift towards SLN mapping with indocyanine green (ICG).13 ICG is a non-radioactive fluorescent dye that is visualised intraoperatively with near-infrared (NIR) fluorescence imaging, providing real-time visual navigation. Recently, the Food and Drug Administration approved ICG for the indication of lymphatic mapping in uterine and cervical cancers.14 Compared with 99mTc, ICG is non-radioactive, cheaper and logistically more attractive. Compared with blue dye, ICG has a better tissue penetration and a lower allergy risk. Overall, the use of ICG may lead to less burden on the patient as its use enables shorter hospital admissions and injection under anaesthesia.15–17 The feasibility of ICG has been demonstrated, and early reports showed ICG yields high SLN detection rates in patients with early-stage cervical cancer.18–21 Limitations of ICG include costs of NIR fluorescence equipment and less guidance towards unexpected SLN positions because of the absence of preoperative imaging.22 Research in prostate cancer therefore suggests that preoperative SLN mapping provided by SPECT/CT remains essential in guiding intraoperative SLN localisation.23 Another pitfall is the tissue penetration of NIR fluorescence imaging of approximately 1 cm, meaning it can be detected through a centimetre of overlying tissue,24 which is especially limiting in patients with a high body mass index (BMI).25 26 Also, the small hydrodynamic diameter of the ICG molecule may result in rapid spreading towards second and third echelon nodes,16 undesirably leading to higher number of removed (false) SLNs. Although clinically the shift towards ICG seems to be in progress, shifting to an easy-to-use technique is not justified without prior evidence of its clinical reliability and validity, wherein it performs at least as good as the current standard of care.
In both endometrial and cervical cancer, adequately powered prospective trials comparing ICG with the more conventional method of 99mTc and blue dye are lacking.27–30 The surgical practice has changed rapidly towards ICG in absence of level A evidence on its diagnostic accuracy. The unexpected recent findings of the Laparoscopic Approach to Cervical Cancer (LACC) trial have again stressed the importance of compelling evidence before switching to a new surgical technique.31 Regarding cervical cancer, a prospective study by Lührs et al compared ICG with intraoperatively administered 99mTc in 65 patients with cervical cancer, without adding blue dye and without performing preoperative SPECT/CT imaging. The researchers reported a significantly higher bilateral detection rate of ICG compared with 99mTc without any significant improvement by combining the two. The lack of preoperative imaging in this study possibly affected the bilateral detection rate of 99mTc negatively, which was low at 60%.32 The Fluorescence Imaging for Lymphatic Mapping (FILM) trial, a randomised non-inferiority trial comparing ICG with blue dye for SLN mapping in predominantly endometrial cancer (n=169, 96%) though also cervical cancer (n=7, 4%), reported significantly higher SLN detection rates with ICG than with blue dye only.30 Besides its limited applicability in cervical cancer, a second major limitation is the absence of a radiotracer, making a comparison between ICG and the conventional combined approach impossible. Regarding endometrial cancer, prospective studies on the accuracy of ICG report greatly varying bilateral detection rates, ranging from 52% to 82%.27–29 33 34 Researchers of the Fluorescence Imaging for Robotic Endometrial Sentinel lymph node biopsy (FIRES) and Sentinel Lymph Node Biopsy vs Lymphadenectomy for Intermediate- and High-Grade Endometrial Cancer Staging (SENTOR) trials report a bilateral detection rate of ICG (52% and 78%, respectively) that is lower than the reported bilateral detection rate of 99mTc with blue dye in relatively large prospective studies (eg, 80.5% in the SENTICOL (Ganglion Sentinelle dans le Cancer du Col) study7).27 29 Soliman et al prospectively studied the bilateral detection rate in patients with endometrial cancer injected with either ICG, blue dye or 99mTc with blue dye.33 Interestingly, the bilateral detection rate appeared to be highest with 99mTc with blue dye (82% vs 52% with ICG only). However, as stated by the authors, the study was not powered to detect a difference in detection rates between the methods (p=0.35). How et al compared the three tracers (blue dye, ICG and 99mTc) simultaneously in 100 patients with endometrial cancer undergoing SLN mapping.34 They found no significant difference in the bilateral detection of ICG versus 99mTc (65% with ICG vs 71% with 99mTc, p=0.36). When they compared ICG to the combination of 99mTc and blue dye, the difference in bilateral detection rate increased in favour of the conventional method: 65% with ICG vs 75% with 99mTc with blue dye. Of note, their results showed that 99mTc was the only tracer that detected all metastatic SLNs, which substantiates that a reliable SLN procedure can impact the survival.
Retrospective cohort studies reporting on the comparison of ICG versus 99mTc combined with blue dye exist but are generally of insufficient quality, underpowered and potentially suffer from publication bias. After a systematic review and meta-analysis of the available literature comparing ICG with 99mTc and blue dye, we found that the pooled bilateral detection rate with ICG appeared to be significantly higher.35 However, in adherence with the Grading of Recommendations, Assessment, Development, and Evaluation guidelines, the quality of evidence was too low to provide strong recommendations and directly omit the combined approach of a radiotracer and blue dye. In addition, all included studies reported a higher average number of identified SLNs when using ICG as a tracer, indicating these are not likely to be all SLNs but rather second echelon lymph nodes. Failing to excise the true SLN could result in missed lymph node metastases. Currently, in both systematic reviews and European guidelines on cervical cancer, no consensus on the use of tracer has been reached, and both methods of SLN detection have been approved.35–37 Before omitting any well-functioning and evidence-based procedure (99mTc combined with blue dye), high-quality evidence on the performance of ICG in cervical cancer SLN mapping is needed. In the FILM trial by Frumovitz et al, it was stated: 'Although the combination of blue dye and radiocolloid might be better than blue dye alone and equivalent to indocyanine green in detecting sentinel nodes, no studies – either prospective or retrospective – have compared the combination of blue dye and radiocolloid with indocyanine green'.30 With our study, we intend to perform the proposed prospective study comparing ICG with the combination of radiotracer and blue dye (including preoperative SPECT/CT) in patients with early-stage cervical cancer. The presumed benefits of ICG are only valuable if its detection rate proves to be at least non-inferior to 99mTc and blue dye.
The Fluorescent Indocyanine Green versus Technetium-99m and Blue Dye for Bilateral SENTinel Lymph Node Detection in Stage I–IIA Cervical Cancer study is initially designed as a prospective, multicentre, non-randomised, single-arm, cross-sectional study in which we compare two SLN methods in patients with early-stage cervical cancer undergoing primary surgical treatment (FIGO stage IA–IB2 or IIA1): ICG with NIR fluorescence imaging versus 99mTc (including preoperative SPECT/CT) and blue dye. The study started in July 2021 and is coordinated by the University Medical Centre Utrecht and monocentric in the rollout phase. We plan to expand this study in other Dutch tertiary referral centres to increase the accrual rate. The planned end date of this study is July 2024.
Given that the current bilateral detection rate using 99mTc combined with blue dye is already high (86% in own cohort) and the use of ICG has substantial benefits, a non-inferiority design is justified.38 When non-inferiority is reached, a switch in standard care to ICG with NIR fluorescence imaging (ie, abandoning 99mTc and blue dye) is supported, which will reduce the physical burden on the patient and logistic and financial burden on the healthcare system. If the detection rate with ICG proves to be inferior to 99mTc with blue dye, the extra burden of the conventional method would be justified as, in the end, patients will benefit most from the highest achievable bilateral detection rate. It is important to note that this is not an equivalence trial. When SLN mapping with ICG produces a higher bilateral detection rate than SLN mapping with 99mTc and blue dye, this is not considered a negative study result, whereas this is clearly a convincing reason to change the current practice. We chose bilateral detection rate as the primary endpoint because bilateral detection of SLNs has been proven to decrease false-negative rate (FNR) and is thus considered to improve reliability and oncological safety.4 39 This protocol has been developed in line with research protocol template of the Central Committee on Research Involving Human Subjects and the SPIRIT recommendations.40
The subjects will be drawn from a population of patients with histopathologically proven primary malignancy of the cervix uteri. Patients are eligible to participate if they are scheduled for a (robot-assisted) laparoscopic or open SLN procedure as part of the standard surgical treatment for FIGO stage IA1–IB2 or IIA cervical cancer (according to the FIGO 2018 guidelines41), aged ≥18 years and able to provide informed consent. Exclusion criteria are pregnancy or current breast feeding, renal insufficiency stage 3 or 4, prior allergic reaction to ICG, 99mTc or patent blue, and prior severe allergic reaction to iodine. Informed consent will be obtained before the start of any study activity.
The sample size calculation was based on our own data and current literature. Data from our historical cohort showed a bilateral detection proportion of 86% (95% CI 80% to 91%) for SLN mapping with 99mTc and blue dye (Hoogendam et al38). The pooled proportion of bilateral detection rate of ICG was found to be between 89.4% and 91.5%, depending on how studies in the meta-analysis were handled (in preliminary analysis). Based on consensus discussion by clinicians in the study team and a comprehensive review of the literature, a non-inferiority margin of 0.05 was set. For assessing non-inferiority in paired proportions, the asymptomatic test statistic, which is the so-called Nam score test, or restricted maximum likelihood estimation-based test statistic was used.42 The power and sample size was calculated in the statistical software package Power Analysis and Sample Size (PASS), verified for non-inferiority tests (one-sided) for two correlated proportions.43 The calculations were checked by a statistician (power formula is provided in the PASS User's Guide43).
In conclusion, comparing a proportion (99mTc and blue dye at 0.86, ICG 0.89) in one sample with a non-inferiority margin of 0.05, with a type I error (α) set at 0.05, a type II error (β) set at 0.2 (power 1−β=0.8) and nuisance set at 0.12 (based on the proportion of discordant pairs), we require a sample size of 101 cases. The complete list of parameters used for the power calculation is provided in online supplemental appendix 1.
Investigational product
ICG is a fluorescent agent used for diagnostic purposes in adults and children with a benign safety profile. One of the diagnostic purposes is fluorescence imaging of lymph nodes and delineation of lymphatic vessels in the cervix and uterus in patients with solid tumours during lymphatic mapping. No therapeutic effects are expected. ICG (VERDYE 25 mg, Diagnostic Green GmbH, Germany) is registered for diagnostic purposes in adults under Dutch RVG number 31 052.
Allergic reactions and anaphylactic shocks due to ICG were reported in very rare (<0.01%) cases. In patients with renal insufficiency, the risk of anaphylactic shock appears to be higher. In very rare cases, spasms of the coronary arteries are described. Radioactive iodine uptake studies should not be performed for at least a week following the use of ICG. No other complications or potential risks of ICG are reported.14
Trial intervention
The flowchart in figure 1 presents a schematic overview of the study design. All subjects undergo an SLN procedure as part of the surgical treatment and receive ICG injection in adjunct to the current combined approach. Subjects will be preoperatively injected with 99mTc followed by a SPECT/CT 90–120 min post injection (according to current standard of care).38 The surgeon (gynaecological oncologist) will not consult the SPECT/CT preoperatively (secured by automated logging of consultation). At the start of surgery, subjects are injected with 4 mL of ICG 1.25 mg/mL (study procedure) and 4 mL of blue dye (standard of care) under general anaesthesia; 1 mL of both tracers into each quadrant of the cervix (ie, at 3, 6, 9 and 12 o'clock, following the internal protocol). During surgery, the SLNs will be first identified with NIR fluorescence light using FireFly fluorescent imaging system (Intuitive Surgical) in robotic surgery or a CE-marked NIR fluorescence platform applicable to laparoscopic or laparotomic surgery; in this light, NIR fluorescent nodes will light up green (figure 2). Localisation of each NIR fluorescent SLN will be reported. When the NIR fluorescent SLN(s) are identified, the gynaecological oncologist will check the SLN(s) for radioactivity with a gamma probe (either in vivo or ex vivo) and blue colour. When completed, the procedure is repeated in the contralateral hemipelvis. Results are reported as follows: of each SLN, the localisation is reported according to a standardised format (see online supplemental appendix 2) and it is stated if detected with NIR fluorescence (ICG), radioactivity (99mTc) and/or blue colour (blue dye). All SLNs identified are excised. After finishing this procedure bilaterally, the surgeon consults the SPECT/CT (time of deblinding is logged both automatically and manually) and reports whether radioactive node(s) on SPECT/CT correspond to the excised SLN(s). To prevent missing SLNs, the pelvic site will be checked for residual radioactive nodes and blue nodes and excised, if present. Residual radioactivity of the surgical site will be measured and deemed negative if background counts are less than 10% of the maximum SLN count.
Flowchart of study procedures. Blue boxes represent the current standard of care; red boxes represent the study-specific procedures. 99mTc, technetium-99m nanocolloid; SPECT-CT, single photon emission computed tomography with X-ray computed tomography; blue dye, patent blue; ICG, indocyanine green; NIR, near-infrared; SLN(s), sentinel lymph node(s).
Fluorescence-guided surgery showing lymphatic vessels (left) and sentinel lymph node (right).
Blue dye and ICG are injected sequentially, before entering the retroperitoneal space. Previous studies using a combined injection of patent blue and ICG experienced no clotting of the two dyes, both at macroscopic and microscopic levels.34 44 45 To prevent from bias in detection of SLNs, injecting blue dye in a later stage of surgery—that is, after SLN mapping with ICG and NIR fluorescence is completed—has been explored. However, starting SLN mapping with ICG would result in anatomical structures and lymphatic vessels that have already been destructed. Because of the destructed lymph vessels, injecting blue dye in a later stage would underestimate the true benefit as the dye will not reach the lymph nodes. This intrapatient study design is thereby limited by the inability of blinding for the outcome of blue dye.
Except for injection of ICG and detection with NIR fluorescence imaging while blinded for the assessment of the SPECT/CT, the complete treatment is maintained according to the current standard of care. Intraoperative recordings and pictures can be made for retrospective tumour-to-background ratio analysis. All follow-up visits take place according to the national guidelines. There is no special follow-up required for subjects in this study. Subjects are asked to fill in the IN-PATSAT32 questionnaire postoperatively, developed by European Organisation for Research and Treatment of Cancer (EORTC), for assessing patients' perception of the quality of hospital-based care (not mandatory).
The primary outcome is bilateral detection rate of SLNs with ICG and NIR fluorescence imaging versus 99mTc (including preoperative SPECT/CT) and blue dye. SLN is defined as the first lymph node(s) of each hemipelvis to receive afferent lymphatic drainage from the primary cervical tumour, identified by either ICG, gamma radiation using 99mTc or blue dye. Bilateral detection is defined as the number of patients detected with at least one SLN in each hemipelvis.
Secondary outcomes include1 overall (ie, at least unilateral) detection rate, sensitivity and FNR of ICG and 99mTc and blue dye, with pelvic lymph node dissection as the reference standard to confirm tumour-positive lymph nodes (part of current standard of care)2; correlation between NIR fluorescent, radioactive (both intraoperative and with SPECT/CT) and blue-stained SLNs in terms of anatomical location3; adverse events of ICG, 99mTc and blue dye4; time to complete SLN detection with ICG versus 99mTc and blue dye5; cost-effectiveness comparison (cost of procedure versus yielded bilateral detection rate) of ICG versus 99mTc and blue dye SLN detection6; surgical evaluation of NIR fluorescent imaging (usability) measured with two short questionnaires tailored for the surgeons; and7 patient satisfaction with the oncological care and procedure measured with the validated EORTC IN-PATSAT32 questionnaire.
The basic clinical, surgical and histopathological parameters will be recorded, including age at diagnosis, BMI (in kg/m2), history of abdominal surgery, American Society of Anaesthesiologists classification, FIGO stage (2018), type of procedure, tumour histology and size, lymph vascular space invasion, nodal count and status, parametrial involvement, vaginal involvement, positive resection margins and adjuvant or adjusted treatment (the latter due to intraoperative finding of positive lymph nodes). Subanalysis will evaluate if these parameters are possible confounders or effect modifiers.
Data collection and management
All measurements will be systematically recorded using an electronic clinical report form built in Castor Electronic Data Capture system. Data will be collected in coded form and monitored by data managers from the UMC Utrecht. Baseline characteristics are collected pseudonymously from the medical records in consultation with the data management department of the research centre(s). All study procedures at the research centre(s) are monitored by an independent monitor during multiple visits according to a specified protocol.
The principal investigators at the research centre(s) bear responsibility for safe data handling. After the project is finished, data will be stored for 25 years according to the current Medical Research Involving Human Subjects Act (WMO). Handling of personal data will comply with the EU General Data Protection Regulation and the Dutch Act on Implementation of the General Data Protection Regulation.
Adverse events are defined as any undesirable experience occurring to a subject during the study, whether or not considered related to the intervention (SLN mapping with ICG and NIR fluorescence). All adverse events reported spontaneously by the subject or observed by the investigator or his staff will be recorded. A serious adverse event (SAE) is any untoward medical occurrence or effect that occurs in the 48 hours following the SLN procedure. The sponsor will report the SAEs through the Dutch web portal ToetsingOnline to the accredited medical ethics research committee that approved the protocol, within 7 days of first knowledge for SAEs that result in death or are life threatening followed by a period of maximum of 8 days to complete the initial preliminary report. All other SAEs will be reported within a period of maximum 15 days after the sponsor has first knowledge of the SAEs.
We will perform a comparison (single sample) of two diagnostic modalities and aim to assess non-inferiority (note: not equivalence) of the ICG SLN mapping in terms of bilateral detection rate. Our analysis is based on previous literature on non-inferiority for paired binary data.42 Statistical software programmes SPSS (version 26.0.0.1 or higher) and R will be used to perform the analyses. The measured primary endpoint is the proportion of bilateral SLN detection, which is tested in a paired setting. The null (H0) and alternative (H1) hypotheses for this non-inferiority study are as follows:
H0: SLN mapping with ICG is inferior to SLN mapping with 99mTc and blue dye with respect to the proportion of bilaterally detected sentinel nodes.
H1: SLN mapping with ICG is non-inferior to SLN mapping with 99mTc and blue dye with respect to the proportion of bilaterally detected sentinel nodes.
The analysis of all outcome data will be performed using intrapatient comparison (McNemars test). Categorical and continuous data will be presented in a quantitative way. The bilateral detection rates of ICG, 99mTc and blue dye are presented separately with corresponding 95% CIs. Categorical data will be analysed using the Fisher exact or χ2, as appropriate. For continuous outcomes, t-test will be used in case of normally distributed data. If not normally distributed, Mann-Whitney U test will be performed. Besides 95% CIs, p values will be reported with a value of <0.05 considered significant.
In case of identified inconsistencies or missing data, additional source documents will be requested from the study site to resolve ongoing inconsistencies. If necessary, patients are called to resolve missing data. If missing data restrict further analysis, multiple imputation analyses will be conducted.
Members of patient organisation Stichting Olijf were involved in the design of this study.
This current study was approved by institutional review board and Medical Research Ethics Committee Utrecht (number 21–014) in accordance with the Dutch WMO and other applicable Dutch and European guidelines, regulations and Acts. The study was registered in the Netherlands Trial Register. All subjects will have to sign and date written informed consent. No study activities will occur prior to obtaining consent. Subjects retain the right to withdraw at any point for any reason. See online supplemental appendix 3 for the approved version of the Dutch patient information and informed consent form for this study (in line with the model form provided by the Central Committee on Research Involving Human Subjects).
This study has been assessed as a low-risk study. ICG is given in adjunct to the current standard of care and subjects are not withheld of any type of standard treatment. Risks associated with participation can be considered negligible. Participating in this study will be associated with minor discomfort and might be beneficial for individuals, as mapping with ICG might result in higher SLN detection rates (based on previous literature). This study intends to improve oncological care and prognosis for all patients with early-stage cervical cancer.
We will ensure our findings and the acquired knowledge will be transferred to clinicians and researchers in the field. Findings arising from this study will be published at national and international conferences. The final manuscript will be submitted for publication to an open access peer-reviewed scientific journal. Both positive and negative trial results will be disclosed. Results will also be updated in the Netherlands Trial Register, which is the primary registry for the Netherlands and recognised and accepted by the WHO and ICMJE. Subjects and patients with cervical cancer will be informed about the study results by the newsletter and social media accounts of patient organisation Stichting Olijf.
This study involves human participants and was approved by Medical Ethics Research Committee, Utrecht (reference number 21-014). The participants gave informed consent to participate in the study before taking part.
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Contributors IGTB: conceptualisation, methodology, writing (original draft) and visualisation. JPH: conceptualisation, methodology, writing (original draft) and validation (as epidemiologist and fellow gynaecological oncology). AJATB: methodology, validation (as radiologist with expertise in nuclear medicine and use of technetium-99m SPECT/CT imaging) and writing (review and editing). WBV: validation (as radiologist with expertise in gynaecological oncology) and writing (review and editing). GNJ: validation (as pathologist with expertise in pathological assessment of sentinel lymph nodes and cervical cancer) and writing (review and editing). IMJ-S: validation (as radiation oncologist with expertise in cervical cancer treatment) and writing (review and editing). RPZ: conceptualisation, methodology, validation (as gynaecological oncologist) and writing (review and editing). CGG: conceptualisation, methodology, validation (as gynaecological oncologist), writing (review and editing) and supervision.
Competing interests RPZ is a proctor for robot-assisted surgery in gynaecological oncology on behalf of Intuitive Surgical.
Patient and public involvement Patients and/or the public were involved in the design, conduct, reporting or dissemination plans of this research. Refer to the Methods and analysis section for further details.


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Business aquarium: what is behind personnel appointments in the Cabinet of Ministers
Oleg Gavrysh
Deputy Chief Editor, The Page
Photo: UNIAN
As usual, I want to inform you of unofficial news and versions that relate to well-known and hidden events in the Ukrainian corporate world, in the business environment, in our aquarium. Here everyone knows everything about everyone, sometimes more than desired.
Today's issue will be focused on the new personnel in the government. As a source in Servant of the People told , there were two reasons why Yuriy Vitrenko was not appointed Deputy Prime Minister and Minister of Energy.
"First of all, Vitrenko was promoted by Ihor Kolomoisky and Victor Pinchuk. Secondly, the Head of the Presidential Administration, Andriy Yermak. Vitrenko promised Kolomoisky at least not to increase, but as a maximum to reduce electricity tariffs for large industrial consumers. It was planned to do this by reducing tariffs for thermal power," the source explained.
According to him, this did not suit Rinat Akhmetov who agreed with the deputies from the group of Ilia Pavlyuk and DmytroRazumkov that they did not vote for Yuriy Vitrenko. The voting was also ignored by the deputies close to Arsen Avakov.
The most unusual story, according to the publication's source, happened with the voting for the allocation of a $4 million premium to Yuriy Vitrenko. The latter promised the Servant of the People faction that the money would be paid to him within several years. But Naftogaz unexpectedly decided to pay off its debts in the near future.
There are at least two versions why. Servant of the People party members say that it was the initiative of the NJSC supervisory board where Vitrenko is disliked. A source close to the Presidential Administration, on the contrary, claims that Andriy Yermak was the initiator. In any case, this payment played a dirty joke on Yuriy Vitrenko.
Some of the deputies refused to vote for him after this decision, referring to the fact that he had broken promises given to the faction.
Vitrenko's appointment remains dubious. The second vote for his candidacy was to be initiated in the Verkhovna Rada tomorrow. But the candidacy was not nominated.
The second story concerns the new Minister of Agrarian Policy and Food. A source in Servant of the People told that Taras Vysotsky, the former Deputy Minister of Economy supervising the agricultural sector, was close to entrepreneurs Yuri Kosiuk and Rinat Akhmetov.
As for the future Minister of Agrarian Policy and Food Roman Leshchenko, he is completely the man of President Volodymyr Zelensky. Thus, the head of state will be able to restore control over the industry.
According to a source in the Presidential Administration, Volodymyr Zelenskyy also received a loyal leader in the head of the Dnipropetrovsk region.
Its current head Valentyn Reznichenko is close to the mayor Borys Filatov and the entrepreneur Hennadiy Korban, who were in strained relations with the previous head of the Regional State Administration Oleksandr Bondarenko.
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